How does this medication work? What will it do for me?

Telmisartan belongs to a class of medications known as angiotensin II receptor antagonists. These medications reduce blood pressure by blocking the actions of a chemical (angiotensin II) that causes blood vessels to constrict or tighten. It is used to treat mild to moderate high blood pressure.

When blood pressure is allowed to remain high for a long time, the blood vessels of the heart, kidneys, and brain may become damaged. This puts a person at increased risk for heart attack and stroke as well as kidney failure and blindness. Keeping blood pressure in the normal range can reduce the risk for these conditions.

Telmisartan is also used to reduce the risk of death after a heart attack in people who cannot use another type of medication called angiotensin-converting enzyme inhibitor.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

40 mg
Each white-to-light yellow, oblong tablet debossed with "T12" one side and plain on the other side contains 40 mg telmisartan. Nonmedicinal ingredients: magnesium stearate, meglumine, povidone, sodium hydroxide, and sorbitol.

80 mg
Each white-to-light yellow, oblong tablet debossed with "T13" one side and plain on the other side contains 80 mg telmisartan. Nonmedicinal ingredients: magnesium stearate, meglumine, povidone, sodium hydroxide, and sorbitol.

How should I use this medication?

The recommended adult dose of telmisartan is 80 mg once a day at approximately the same time each day, with or without food. It will take about 2 weeks for reductions in blood pressure to become noticeable and another 2 weeks until the full effects of the medication are realized. People with reduced liver function are usually given 40 mg once daily to start.

It is important to take this medication regularly and to follow your doctor's instructions regarding blood pressure monitoring to ensure that you are getting the maximum benefit from the medication.

If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Store telmisartan at normal room temperature in a dry place (not in the bathroom) and keep it out of the reach of children. Do not remove tablets from their blister-pack until you are ready to take them.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take telmisartan if you:

are allergic to telmisartan or to any of the ingredients of the medication

have experienced angioedema as a reaction to any angiotensin receptor blocker (ARB)

are pregnant or plan to become pregnant

are breast-feeding

have diabetes or kidney disease and are taking the medication aliskiren

are allergic to certain sugars (fructose and/or sorbitol intolerant)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

anxiety

back or leg pain

constipation

diarrhea

difficulty sleeping

dizziness

dry mouth

eczema or skin rash

headache

heartburn

joint pain

muscle cramps or spasms

nausea

nervousness

rash

tiredness

upper respiratory tract infection (such as colds or sinus infections)

upset stomach

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

HEALTH CANADA ADVISORY

February 4, 2014

Health Canada has issued new restrictions concerning the use of telmisartan. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: Telmisartan may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.

Kidney disease: Telmisartan may affect kidney function, especially for people who already have kidney problems. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver disease: Telmisartan is removed from the body by the liver. On rare occasions, it may cause liver problems. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low blood pressure: If you have orthostatic hypotension (a sudden drop in blood pressure caused by standing up, which may lead to fainting), you should be cautious while taking telmisartan, as it can worsen the condition. The first time this medication is taken, it may cause dizziness, lightheadedness, or fainting. This may be reduced by taking the medication in a sitting position and being careful to rise slowly to a standing position. The dizziness usually improves after the first dose, but if the medication is stopped and then started again, it may reappear. Your doctor may also adjust the dose.

Potassium levels: This medication may affect potassium levels in the blood, especially when used for heart failure, or when taken with other medications called ACE inhibitors or diuretics such as spironolactone. Your doctor will monitor your potassium levels while on this medication. Avoid using salt substitutes that contain potassium while you are taking telmisartan.

Pregnancy: Telmisartan may cause severe harm to an unborn fetus and should not be taken during pregnancy. If you discover you are pregnant while taking this medication, stop taking the medication and tell your doctor at once.

Breast-feeding: It is not known if telmisartan passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children:The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between telmisartan and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,

change one of the medications to another,

change how you are taking one or both of the medications, or

leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.